Improving Access to Home Dialysis Act aims to reduce barriers to treatment and increase access to care
(April 22, 2024, Washington, DC) —The National Kidney Foundation (NKF) is applauding a move by Congress to increase access to care and improve outcomes for some patients on dialysis. The Improving Access to Home Dialysis Act (HR-8075) was introduced today in the U.S. House of Representatives by Reps. Carol Miller (R-WV), Marilyn Strickland (D-WA), Earl Blumenauer (D-OR), and Mariannette Miller-Meeks (R-IA). A companion bill is expected to be introduced soon in the Senate.
Home dialysis is a form of renal (kidney) replacement therapy (aka, dialysis) that can be done at home by the patient alone or with the help of a care partner. While home dialysis is not for everyone, it can offer patients convenience and flexibility to do their treatments in the comfort of their own homes and without a rigid dialysis schedule set for them. The therapy can be especially useful to patients in rural or remote areas who have to travel long distances to reach a dialysis facility. This flexibility can greatly improve the quality of life for patients and help them be more likely to maintain employment and remain healthy enough to qualify for transplantation.
Only 14% of patients on dialysis in the US are using at-home options, despite evidence showing that it may be a better option for some (but not all) patients(1). Lack of information is a major barrier as many patients are not informed there are options beyond the traditional in-center care.
“Patients deserve to know about all options for dialysis so they can make an educated choice for themselves,” said Kevin Longino, Chief Executive Officer of the National Kidney Foundation and a kidney transplant recipient. “Too many patients are never told they have options, besides in-center dialysis, that could improve their quality of life. We are deeply appreciative of Reps. Miller, Strickland, Blumenauer, and Miller Meeks for their introduction of the Improving Access to Home Dialysis Act, which will help more patients learn about and gain access to home dialysis.”
The Improving Access to Home Dialysis Act will:
Mandate that patients get proper education on all of their dialysis options, including making sure that even patients who crash onto dialysis with no preparation can get education on other options once they have stabilized and can make informed decisions about their future.
Expand the universe of healthcare providers who can provide home dialysis training to remove the burden from the nursing staff and cut down on wait times to get trained. It would also allow for the use of group training, telehealth, and off-site training when appropriate.
Cover the costs of in-home healthcare support staff for patients when they are beginning their home dialysis journey. This in-home assistance would help patients transition from the facility and support the patient and if available, their care partner, with the goal that they become fully independent over time. Some patients with certain disabilities or other concerns could be eligible for continuing in-home assistance.
Patients and advocates who have been able to utilize Home Dialysis in the past are also voicing their support.
“In 2001, I was fortunate to be offered home hemodialysis soon after I crashed into End Stage Kidney Disease (ESKD),” said Erich Ditschman, an NKF volunteer from Michigan. “Home dialysis gives me the energy and health to be a better husband, father, and friend. Many of the patients on in-center dialysis may not know home dialysis exists or have not been given the opportunity to use it. Once passed and signed, this legislation will help to make home dialysis much more accessible, especially to rural patients. It will save lives and help many ESKD patients to flourish.”
"I am grateful to Reps. Miller, Strickland, Blumenauer, and Miller Meeks for spearheading this push to make home dialysis more accessible for us,” said Bell Maddux, an NKF advocate from Pennsylvania. “Policies like this make me increasingly optimistic that more kidney patients struggling with dialysis can have a chance to get some of their life back.”
Additional Resources Bill: Improving Access to Home Dialysis Act
Press Release from Rep. Carol Miller (R-WV)
Press Release from Rep. Mariannette Miller-Meeks (R-IA) NKF Article: Making the Case for Home Dialysis
Additional background: Erich Ditschman: Michigan Advocate to Receive Award
Additional background: Bell Maddux: Testimony to the House Ways & Means Committee on Home Dialysis
About Kidney Disease In the United States, more than 37 million adults are estimated to have kidney disease, also known as chronic kidney disease (CKD)—and approximately 90 percent don’t know they have it. About 1 in 3 adults in the U.S. are at risk for kidney disease. Risk factors for kidney disease include: diabetes, high blood pressure, heart disease, obesity, and family history. People of Black or African American, Hispanic or Latino, American Indian or Alaska Native, Asian American, or Native Hawaiian or Other Pacific Islander descent are at increased risk for developing the disease. Black or African American people are about four times as likely as White people to have kidney failure. Hispanics experience kidney failure at about double the rate of White people.
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